A lot of us ignore or overlook the bluish or brownish discolouration around the ankles that can extend up the lower part of the legs. Others notice twisted, bulging veins but assume they are only a cosmetic concern. Varicose veins, however, can sometimes cause aching, heaviness, swelling, itching and skin changes, particularly after standing or sitting for long periods.
For some people, lifestyle measures and observation are enough. For others, treatment may be recommended when symptoms become troublesome or when there are complications such as skin changes or ulcers. Today, treatment does not necessarily mean traditional vein surgery. Endovenous laser ablation and other minimally invasive treatments have changed how many varicose veins are managed.
What Are Varicose Veins?
Varicose veins are enlarged, twisted veins that usually appear close to the surface of the skin, most commonly in the legs. They develop when the valves inside the veins do not work properly, allowing blood to flow backwards and collect in the veins. This increased pressure can gradually cause the veins to enlarge and become visible. They may appear dark blue or purple and can look like twisted cords beneath the skin.
Some people have no symptoms at all. Others may experience:
- An aching or heavy feeling in the legs
- Swelling, particularly around the ankles
- Throbbing, burning or cramping
- Itching around the affected veins
- Pain that becomes worse after prolonged standing or sitting
- Changes in skin colour
- Skin inflammation or, in more advanced cases, ulcers
Varicose veins are therefore not always simply a cosmetic issue. When symptoms or complications develop, a vascular assessment can help determine whether treatment is appropriate.
Why Do Varicose Veins Develop?
The risk of developing varicose veins increases with age, and they are more common during pregnancy. Family history, obesity and spending long periods standing or sitting may also increase the likelihood of developing them.
Pregnancy deserves particular mention. Hormonal changes, increased blood volume and pressure from the growing uterus can contribute to venous problems. Some pregnancy-related varicose veins improve after delivery, while others may persist.
When Do Varicose Veins Need Treatment?
Not every visible varicose vein needs a procedure. A doctor may recommend treatment when there are troublesome symptoms or complications such as skin changes, inflammation, bleeding or venous ulceration.
A duplex ultrasound is commonly used to confirm the diagnosis, identify abnormal blood flow or reflux, and map the veins before treatment. This is an important step because the veins visible on the skin may be only part of the underlying problem.
What Is Traditional Surgery for Varicose Veins?
Traditional varicose vein surgery usually involves ligation and stripping, where the affected vein is tied off and, when appropriate, removed. Smaller surface veins may also be treated with procedures such as phlebectomy.
This approach has been used for many years and remains an option when endovenous treatment is unsuitable or when the patient's anatomy and clinical condition make surgery more appropriate.
However, treatment has changed considerably over the years. For suitable patients with truncal venous reflux, current guidance generally recommends endothermal ablation before conventional surgery because it is less invasive and is associated with faster recovery.
What Is Laser Treatment for Varicose Veins?
Endovenous laser ablation (EVLA) is a minimally invasive treatment in which a thin laser fibre is introduced into the affected vein through a small puncture. Ultrasound is used to guide the fibre accurately.
Laser energy heats the inside of the vein, causing it to close. Blood is then redirected through healthier veins.
The procedure does not involve removing the entire vein through a surgical incision. This generally means less tissue disruption and a shorter recovery compared with traditional stripping in appropriately selected patients.
Laser vs Traditional Surgery: What Is the Difference?
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The choice is not simply about choosing the newer procedure. The anatomy of the veins, the location and extent of reflux, symptoms, previous treatment and overall health all influence the decision.
What Does Varicose Vein Treatment Cost in India?
The final cost of varicose vein treatment depends on the city, hospital, surgeon or interventional specialist, number of veins or legs being treated, imaging requirements, type of procedure, anaesthesia, consumables and whether additional procedures such as phlebectomy or sclerotherapy are required.
Laser treatment may cost more than traditional surgery because it involves specialised equipment, imaging guidance and endovenous technology. The figures are usually ₹60,000–₹1,50,000 for laser treatment or ₹40,000–₹1,00,000 for surgery. For an accurate estimate, the patient first needs a clinical examination and, where indicated, duplex ultrasound. The treatment plan can then be matched with the actual extent of venous disease.
Varicose Vein Treatment at STAR Hospitals
At STAR Hospitals, Hyderabad, the vascular surgery department manages venous disorders including varicose veins and offers several treatment options, ranging from compression stockings and sclerotherapy to laser therapy and vein surgery. Our varicose vein treatment is usually performed using minimally invasive procedures.
The Interventional Radiology department specifically offers laser ablation for varicose veins, along with image-guided vascular procedures. Our vascular specialists are experienced in advanced varicose vein treatments like Dr. Venu Gopal Kulkarni in endovenous ablation using laser and radiofrequency and Dr. V. Apoorva, Consultant in Vascular & Endovascular Surgery in advanced laser procedures and sclerotherapy for varicose veins.
